Background: Limited data exist on factors predicting prolonged survival in left ventricular assist device (LVAD) recipients. We sought to identify patient characteristics and complications associated with prolonged survival.
Methods: We conducted retrospective review of the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) database, including primary continuous-flow LVAD recipients, between May 2012 and March 2013. Patients were identified as having survived with a device in place after 3 years or not, conditional on having initially survived 6 months. Patients who received a transplant, underwent explant due to recovery, or were lost to follow-up before 3 years were excluded. Multivariate logistic regression evaluated perioperative factors and adverse events within 6 months associated with long survival.
Results: Of 1,116 patients who survived past the initial 6 months, 725 (65%) survived beyond 3 years. On univariate analysis, long-term survivors were significantly younger, were less likely to be white, supported for destination therapy, have diabetes, solid-organ cancer, or take amiodarone. On multivariate analysis, factors associated with increased odds of death at 3 years included diabetes, amiodarone use, and developing stroke, gastrointestinal bleeding, hemolysis, or pump thrombosis within 6 months of implantation.
Conclusions: Preoperative diabetes and amiodarone use were associated with poor long-term survival in LVAD recipients. Development of early complications of stroke, gastrointestinal bleeding, hemolysis, or pump thrombosis was also associated with poor long-term survival. Early diagnosis and treatment of these complications may improve survival in LVAD recipients.
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http://dx.doi.org/10.1016/j.athoracsur.2018.08.054 | DOI Listing |
Rev Cardiovasc Med
January 2025
Center for Preclinical Surgical & Interventional Research, The Texas Heart Institute, Houston, TX 77030, USA.
The evolution of left ventricular assist devices (LVADs) from large, pulsatile systems to compact, continuous-flow pumps has significantly improved implantation outcomes and patient mobility. Minimally invasive surgical techniques have emerged that offer reduced morbidity and enhanced recovery for LVAD recipients. Innovations in wireless power transfer technologies aim to mitigate driveline-related complications, enhancing patient safety and quality of life.
View Article and Find Full Text PDFArtif Organs
January 2025
Division of Cardiology, Department of Medicine, Columbia University College of Physicians and Surgeons and NewYork-Presbyterian Hospital, New York, New York, USA.
Background: GLP-1 RAs improve cardiometabolic outcomes in obese, diabetic, and heart failure patients. Data on the safety and efficacy of GLP-1 RA in advanced heart failure with durable LVAD is limited.
Objectives: To assess the safety and efficacy of GLP-1 RA in durable LVAD patients.
World J Pediatr Congenit Heart Surg
January 2025
The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Background: With an increasing number of Fontan patients surviving into adulthood, the burden of end-stage heart failure is increasing. Prior studies have reported suboptimal heart transplantation (HTx) outcomes. Therefore, the authors describe their institutional experience of HTx in patients with Fontan circulation failure, including heart-liver transplantation (HLTx) and pretransplant systemic ventricular assist device (SVAD) therapies.
View Article and Find Full Text PDFHeart Rhythm
January 2025
Department of Cardiovascular Medicine, Section of Cardiovascular Imaging, Cleveland Clinic Foundation, Cleveland, OH. Electronic address:
Background: Better risk stratification is needed to evaluate patients with non-ischemic cardiomyopathy (NICM) for prophylactic implantable cardioverter-defibrillators (ICD). Growing evidence suggests cardiac magnetic resonance imaging (CMR) may be useful in this regard.
Objective: We aimed to determine if late-gadolinium enhancement (LGE) seen on CMR (dichotomized as none/minimal <2% vs significant ≥2%) predicts appropriate ICD therapies (primary endpoint) and/or all-cause mortality/transplant/left-ventricular assist device (LVAD) implantation (secondary endpoint) in NICM patients.
Artif Organs
January 2025
Istituti Clinici Scientifici Maugeri IRCCS, Cardiology Rehabilitation Unit of Gattico-Veruno Institute, Gattico-Veruno, Italy.
Background: Left Ventricular Assist Device (LVAD) implantation is an important treatment option for patients with advanced CHF. Referral to an early, intensive cardiac rehabilitation (CR) program in these patients seems still underused. This observational descriptive study aimed to evaluate the feasibility and efficacy of an early intensive CR program in LVAD recipients, also comparing results with a matched group of advanced HFrEF patients.
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